1366708083 NPI number — DR. JAMES S BANKS MD

Table of content: DR. JAMES S BANKS MD (NPI 1366708083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366708083 NPI number — DR. JAMES S BANKS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BANKS
Provider First Name:
JAMES
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366708083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7623
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34101-7623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-712-7229
Provider Business Mailing Address Fax Number:
305-397-1139

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20900 BISCAYNE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-682-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  ME124047 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 021805800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14264314 . This is a "CAQH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P02252689 . This is a "FL RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: IZ989Y . This is a "FLORIDA MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: KJWW1 . This is a "FLORIDA BLUE (BCBS)" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 021805800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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